New wellness and prevention benefits under the Affordable Care Act (ACA) are offering insurers and hospitals a prime opportunity to engage newly enrolled Hispanic and multicultural consumers into their health care circle. ACA made obesity screening and counseling one of several “preventative services benefit,” which can be utilized as a potential entry point to bring these groups onboard and bond them in a relevant way with insurers and hospital brands.

New wellness and prevention benefits under the Affordable Care Act (ACA) are offering insurers and hospitals a prime opportunity to engage newly enrolled Hispanic and multicultural consumers into their health care circle. ACA made obesity screening and counseling one of several “preventative services benefit,” which can be utilized as a potential entry point to bring these groups onboard and bond them in a relevant way with insurers and hospital brands.

While obesity is a national epidemic in the U.S., according to the Office of Minority Health, it is an even greater health concern for multicultural segments. Multicultural populations are plagued with the highest obesity rates across all segments, with nearly 4 out of 5 Mexican-American and African American women being overweight or obese versus 3 in 5 White non-Hispanic women.[1]When considering the “tsunami of chronic diseases” arising from obesity, particularly diabetes, heart disease, sleep apnea, asthma, depression and increased mortality, the benefits for engagement of these segments through obesity detection and management can go beyond strong brand connection to positive clinical outcome.

Engaging Hispanics and Multicultural consumers, however, will require a culturally nuanced approach since traditionally Hispanics are the least likely to see a doctor regularly and most often seek attention once symptoms have progressed. According to SSG’s Wellness Spectrum Model™ powered by GfK-MRI, the most wellness-minded individuals are the most likely to visit medical professionals regularly while the wellness-averse individuals are the most likely to procrastinate seeing a doctor and only go when seriously ill (see Chart). Engaging newly insured who are Wellness-Minded or Wellness-Ambivalent individuals could prove most cost efficient and may also deliver the best medical outcomes.

Another important cultural consideration is that many of the newly insured Hispanics and Multiculturals are first time users and may require more assistance navigating the world of insurance and medical services. Having services available in-language and in-culture is critical to break through barriers and attain desired medical outcomes. Engaging them in preventative health programs, offered in-language & in-culture, can offer a chance to change the traditional health paradigm from “waiting until illness strikes” to “being proactive, partners in health.

Obesity makes an ideal case study for examining how this preventative health benefit can be utilized to engage Hispanic and multicultural consumer. A review of obesity studies identified six key culturally-sensitive/culturally-competent programs factors which increase the effective intervention and successful adoption of obesity treatment programs among Hispanic and multicultural populations:

Distinct Cultural Body & Weight Perceptions – Much research has pointed at a significant disparity in perception and awareness of weight and obesity among Hispanics and African Americans. Among Asian and non-Hispanic white, the ideal body image is much more lean, but it is not as ideal among African-American and Latino cultures.2 In fact, weight and obesity misperception are significantly higher among black women –3 to 5 times at greater odds than their white ocunterparts.3 Obesity tolerance is largely processed through cultural glasses. A recent study by the University of Alabama found that socioeconomic status, education, fruit and vegetable intake, and physical exercise explains only 10 percent of the differences in obesity between non-Hispanic white women and African American women.4 Genetics and culture may play a much larger role in obesity than previously believed.

Traditional Foods Tied to Cultural Heritage & Identity – It is extremely hard to shift any family to a low-fat diet. It is certainly even harder for families that have close bonds to cultural roots which are manifested in traditional foods, specialty cuisines, and celebratory rituals. After migration, culture is kept alive through cooking habits passed down through generations. Diets or weight programs like Jenny Craig, NutriSystem, or the Mediterranean Diet might prove challenging to maintain for those with strong cultural food traditions, such as tortillas, fried chicken, or fried plantains. Diet programs that acknowledge and embody cultural palates and norms are much more practical for traditional multicultural families faced with changing dietary behaviors.

Socioeconomic Barriers/Issues – Hispanic and African American families often face more pressing issues relating to daily survival such as employment, safety, limited finances, immigration status, language barriers, and education, which take priority over the issues of overweight and obesity. Tighter budgets in unsafe urban neighborhoods lead to unhealthy food alternatives and physical inactivity.

Language Issues – Researchers found that language barriers blocked full engagement into the obesity treatment programs, as it limited understanding medical issues, nutrition aspects, and cooperation in the activities. Materials and programs must be presented in-language to deliver results and build cooperative relationship.

Health Literacy – Although they understand how being overweight has an extensive impact on other health problems, many of the Hispanics and multicultural participants in studies lack the sufficient health knowledge to be able to understand BMI screening tools, being overweight versus obesity and food and nutrition knowledge.

Physical Activity – Several studies note that currently the most practiced obesity models revolves around diet, BMI and Weight Maintenance. Physical activity is so important to success that medical community needs to design long-term programs and methods to keep patients engaged in physical activity. Exercise programs and methods, however, must factor in cultural nuances, because what seems natural in the American culture may not be traditionally accepted in other cultures. For example, a recent Latina immigrant wanting to go for an evening walk is very likely to encounter lower acceptance and support from her Latino husband, impacting her motivation and perseverance. Such distinct cultural nuances should be considered in any dietary or physical program development.

Insurers, hospitals and medical professionals who wish to capture some of ACA’s newly insured may want to develop a culturally competent engagement program for obesity as a means of establishing their brand and image within the newly insured Hispanic and multicultural segments. Utilizing programs with a relevant in-culture/in-language approach will help:

Effective intervention, treatment, patient & family care and support

Educate newly insured on a proactive health lifestyle and the new healthcare system

Establish a genuine awareness and connection with your brand

Build trusted partnerships in health care

Result in strong brand ambassadors with family and friends, in these highly social and connected communities

A successful, targeted, preventative health care engagement model can then be replicated across other conditions, such as Diabetes and Cardiovascular disease, resulting in on-going connections to your health care image and brands, building loyalty and improving health outcomes. Proactive outreach efforts will also provide the additional benefit of beginning to close the historical disparities that have long existed among Hispanics and multicultural segments in health care access, education, behavior and treatment.

SSG is hosting a webinar on Wed. July 16, 2014, 2p ET/11a PT, to discuss capitalizing on opportunities for ACA’s 2nd Open Enrollment period, best practices, the challenges ahead, and the impact of bonding through culturally relevant, preventative care engagement models.

Sources:
[1]http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=5372 The North American Association for the Study of Obesity’s 20073 Differences in Weight Perception Among Blacks and Whites, Hendley, Zhao, Vaccarino; Part of META-Health Study; Journal of Women’s Health4 The mysteries behind minority obesity disparities; Apr 21, 2014 By Hope Gillette based on new research from the University of Alabama at Birmingham.

About SSGSSG is a growth consulting leader driven by management P&L experience, Big Data and predictive analytics. We develop fact-based business models, insights, customer experiences and roadmaps that profitably segment distinct customer groups and drive revenue. Find more about how we may help you attain your growth goals at https://santiagosolutionsgroup.com/ or follow us on Twitter at @Santiago_Group and in LinkedIn at Santiago Solutions Group.